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Graft-Versus-Host Disease

Cyclosporine A and Mycophenolate Mofetil vs Cyclosporine A and Methotrexate for graft-versus-host disease prophylaxis after stem cell transplantation from HLA-identical siblings

Bone Marrow Transplantation volume 35, pages 1089–1093 (2005)Cite this article

Summary:

The combination of Cyclosporin A (CSA) and Methotrexate (MTX) is considered to be the standard regimen for the prevention of graft-versus-host disease (GVHD) after stem cell transplantation (SCT) from HLA-identical siblings. Mycophenolate Mofetil (MMF) has been widely used for GVHD prophylaxis after nonmyeloablative SCT, but experience following myeloablative therapy is still limited. We retrospectively compared CSA/MTX and CSA/MMF in 93 patients (median age 35 years, range 17–59 years, male subjects 48, female subjects 45) with acute myeloid leukemia (n=33), myelodysplastic syndrome (MDS) (n=3), acute lymphoblastic leukemia (ALL) (n=20) or chronic myeloid leukemia (n=37) who received CSA/MMF (n=26) or CSA/MTX (n=67) as GVHD prophylaxis following high-dose therapy and allogeneic SCT from HLA-identical siblings. No statistically significant differences were found in overall survival, relapse rate, treatment-related mortality and acute or chronic GVHD. Time to myeloid recovery was significantly shorter in patients who received CSA/MMF. We conclude that the combination of CSA/MMF appears equivalent to CSA/MTX for GVHD prophylaxis in patients receiving conventional-intensity SCT from HLA-identical siblings.

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Acknowledgements

We thank the clinical and laboratory staff of the Department of Haematology, Oncology and Clinical Immunology of the Heinrich-Heine University Duesseldorf as well as our colleagues from the Institute for transplant diagnostics and cellular therapy (ITZ). This work was generously supported by the Leukämie-Liga e.V.

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  1. Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine University, Duesseldorf, Germany, Moorenstr. 5, Duesseldorf, Germany

    F Neumann, T Graef, C Tapprich, M Vaupel, U Steidl, U Germing, R Fenk, R Haas & G Kobbe

  2. Wissenschaftlicher Service Pharma Gmbh, WISP, Karl-Benz-Str. 1, Langenfeld, Germany

    A Hinke

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  1. F Neumann
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Correspondence to F Neumann.

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Neumann, F., Graef, T., Tapprich, C. et al. Cyclosporine A and Mycophenolate Mofetil vs Cyclosporine A and Methotrexate for graft-versus-host disease prophylaxis after stem cell transplantation from HLA-identical siblings. Bone Marrow Transplant 35, 1089–1093 (2005). https://doi.org/10.1038/sj.bmt.1704956

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